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Topiramate to Prevent Pediatric Migraine Headaches: A Systematic Review

1 October 2010


Objectives: Neurogenic inflammation plays a key part in the development and continuation of migraine headaches. Treatment of migraines includes acute attack medications, avoidance of triggers, and preventative treatment. Currently there are no FDA approved preventative medications for treatment of pediatric migraines. Pediatric migraines have long been unrecognized and undertreated. This systematic review evaluates RCT’s that have studied prophylactic treatment of migraines with topiramate.

Methods: An thorough search of PubMed, Medline, Cinhahl, and EBM Reviews of the Pacific University Library Database which compiles the Cochrane Database of Systematic Reviews, ACP Journal Club, and Cochrane Central Register of Controlled Trials for potential randomized, double-blind, placebo-controlled, parallel studies was conducted to discover studies connected to the question.

Results: A pooled analysis of three trials involving 307 patients suggest a moderate benefit when topiramate is given to children between 6 and 17 for prevention of migraine headaches. The decrease in migraine frequency reported by was statistically significant in two of the studies.

Conclusions: Topiramate is an effective preventative medication, with mild to moderate side effects, for managing pediatric migraines.


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